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81.
Charlie Dharmasukrit Sut Yee Shirley Chan Richard L. Applegate Daniel J. Tancredi Theresa A. Harvath Jill G. Joseph 《The Journal of arthroplasty》2021,36(6):1895-1903
BackgroundAlthough frailty has been shown to be associated with adverse outcomes in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA), prior studies have not examined how race/ethnicity might moderate these associations. We aimed to assess race/ethnicity as a potential moderator of the associations of frailty and functional status with arthroplasty outcomes.MethodsThe National Surgical Quality Improvement Program was queried for patients who underwent THA or TKA from 2011 to 2017. Frailty was assessed using the modified frailty index. Regression analyses were conducted to examine associations connecting frailty/functional status with 30-day readmission, adverse discharge, and length of stay (LOS). Further analyses were conducted to investigate race/ethnicity as a potential moderator of these relationships.ResultsWe identified 219,143 TKA and 130,022 THA patients. Frailty and nonindependent functional status were positively associated with all outcomes (P < .001). Compared to White non-Hispanic patients, Black non-Hispanic patients had higher odds for all outcomes after TKA (P < .001) and for adverse discharge/longer LOS after THA (P < .001). Similar associations were observed for Hispanics for the adverse discharge/LOS outcomes. Race/ethnicity moderated the effects of frailty in TKA for all outcomes and in THA for adverse discharge/LOS. Race/ethnicity moderated the effects of nonindependent function in TKA for adverse discharge/LOS and on LOS alone for THA.ConclusionDisparities for Black non-Hispanic and Hispanic patients persist for readmission, adverse discharge, and LOS. However, the effects of increasing frailty and nonindependent functional status on these outcomes were the most pronounced among White non-Hispanic patients. 相似文献
82.
83.
Luis I. Ruffolo Marsha Pulhamus Theresa Foito Elizabeth Levatino Heather Martin Julie Michels Jan Schriefer Kori Wolcott Derek Wakeman 《Journal of pediatric surgery》2021,56(1):30-36
PurposePediatric gastrostomy tubes (G-tubes) are associated with considerable utilization of healthcare resources. G-tube dislodgement can result in tract disruption and abdominal sepsis. We aimed to reduce early G-tube dislodgement by 25%.MethodsAn interdisciplinary team convened to identify key drivers of G-tube dislodgement and implement initiatives to reduce this complication. A G-tube care bundle was implemented in 2018. Rates of early G-tube dislodgement (within 90 days of insertion) were tracked. 15 months of cases after bundle implementation were compared to 20 months of cases before implementation. Length of stay (LOS, balancing measure) and bundle compliance (process measure) were tracked.ResultsG-tube dislodgements decreased 47% after bundle implementation. Overall, dislodgements after G-tube insertion decreased from 43% to 19% dislodgements per tube inserted, p = 0.004. Reductions were observed for dislodgements occurring in both the inpatient (14% vs. 1.5%) and outpatient (29% vs. 18%) settings. Median LOS was reduced from 15.3 to 7.1 days following implementation, p = 0.004. Process measures demonstrated 75% or greater compliance one year after implementation.ConclusionAn interdisciplinary team using quality improvement science methodology can significantly reduce G-tube dislodgement and improve value after pediatric gastrostomy tube insertion.Type of studyLongitudinal cohort study.Level of evidenceIII. 相似文献
84.
85.
Annals of Surgical Oncology - 相似文献
86.
Olasveengen Theresa M. Semeraro Federico Ristagno Giuseppe Castren Maaret Handley Anthony Kuzovlev Artem Monsieurs Koenraad G. Raffay Violetta Smyth Michael Soar Jasmeet Svavarsdóttir Hildigunnur Perkins Gavin D. 《Notfall & Rettungsmedizin》2021,24(4):386-405
Notfall + Rettungsmedizin - Der Europäische Rat für Wiederbelebung hat diese Leitlinie – Basismaßnahmen zur Wiederbelebung – auf Grundlage des... 相似文献
87.
D. Scott Kreiner Paul Matz Christopher M. Bono Charles H. Cho John E. Easa Gary Ghiselli Zoher Ghogawala Charles A. Reitman Daniel K. Resnick William C. Watters Thiru M. Annaswamy Jamie Baisden Walter S. Bartynski Shay Bess Randall P. Brewer R. Carter Cassidy David S. Cheng Sean D. Christie Amy M. Yahiro 《The spine journal》2021,21(4):726-727
88.
John W. Bracey Mark A. Tait Sophie B. Hollenberg Theresa O. Wyrick 《Hand (New York, N.Y.)》2021,16(2):253
Background: Telemedicine is an evolving tool to increase patients’ access to subspecialty care. Since 2014, Arkansas has been utilizing telemedicine in the evaluation of patients with hand injuries. The purpose of this study is to assess the effect of this novel telemedicine system for the management of hand trauma on patient transfer. Methods: We reviewed data from the first year of the telemedicine program (2014) and compared it to data from the year prior (2013). Data collection from both years included number of hand consults and need for transfer. From the 2014 data, we also recorded the use of telemedicine, type of transfer, distance of transfer, and time to disposition. Results: During 2013 (pre-telemedicine), there were 263 hand traumas identified. In all, 191 (73%) injuries required transfer to a higher level of care, while 72 (23%) were managed locally. In the first year of the telemedicine program (2014), a total of 331 hand injuries were identified. A total of 298 (90%) resulted in telemedicine consultation with 65% (195) utilizing video encounters. After telemedicine consultation, local management was recommended for 164 injuries (55%) while transfer was recommended for 134 (45%). Using telemedicine, there was a significant decrease in the percentage of transfer for hand injuries (P < .001). Conclusions: The telemedicine program was well utilized and provided patients throughout the state with continuous access to fellowship trained hand surgeons including regions where hand subspecialty care is not available. The program resulted in a significant decrease in the number of hospital transfers for the management of acute hand trauma. 相似文献
89.
Charlotte V. Hobbs Jan Drobeniuc Theresa Kittle John Williams Paul Byers Panayampalli S. Satheshkumar Kengo Inagaki Meagan Stephenson Sara S. Kim Manish M. Patel Brendan Flannery CDC COVID- Response Team CDC COVID- Response Team Bailey Alston Shanna J. Bolcen Darbi Boulay Peter Browning Li Cronin Ebenezer David Tonya Hayden Han Li Travis Lim Panagiotis Maniatis Palak Patel Mathew Pauly Amanda Poe Lili Punkova Vera Semenova Evelene P. Steward-Clark Alexandra Tejada Briana Zellner 《MMWR. Morbidity and mortality weekly report》2021,70(9):312
90.
Laurie H. Seaver Suzanne B. Cassidy 《American journal of medical genetics. Part A》1991,41(4):405-409
We report on a mother and son with a similar syndrome of hypertelorism and telecanthus, epicanthal folds, downslanting palpebral fissures, ptosis, broad nasal bridge, malar hypoplasia, thin upper lip, smooth philtrum, and apparently low-set prominent ears. The son also has a hypoplastic shawl scrotum, cryptorchidism, and genu valgum. His language development was delayed at 18 months, but subsequently improved and was normal at age 3. The mother has the additional findings of marked cubitus valgus, hyperextensible joints, dull normal intelligence and a bleeding diathesis. This pattern of multiple congenital anomalies may represent a new syndrome. 相似文献